Nursing Ethics最新文献

{"title":"Nursing ethics and the perspectivity of nursing: Response to '30 years of nursing ethics'.","authors":"Settimio Monteverde","doi":"10.1177/09697330251322268","DOIUrl":"10.1177/09697330251322268","url":null,"abstract":"","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"696-697"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The nurses' clinical environment belongingness and professional identity: The mediating role of professional values.","authors":"Somaye Bakhshi Zadeh, Ali Mohammad Parviniannasab, Mostafa Bijani, Azizallah Dehghan, Aezam Zare","doi":"10.1177/09697330241268901","DOIUrl":"10.1177/09697330241268901","url":null,"abstract":"<p><p>BackgroundBelonging to the clinical environment and the professional values of the performers play a role in forming a professional identity. Therefore, it is necessary to understand the degree of connection among these concepts.AimThis study aimed to examine the mediating effects of professional values on the relationship between nurses' clinical environment belongingness and professional identity.DesignIn the present study, a descriptive cross-sectional multicenter design was used.Participants and research contextA convenient sample of 635 nurses recruited from three hospitals in Fars Province, Southern Iran, from September 2023 to January 2024. Nurses Professional Values Scale-Revised, Clinical Environment Belongingness Scale, and Professional Identity Scale were used to collect the data. The mediation model was analyzed using SPSS v27 and the Process Macro 4.0.Ethical considerationsThe protocol of this study was approved by the Research Ethics Committee of Fasa University of Medical Sciences, and informed consent was obtained from all nurses. The study conforms to the principles outlined in the Declaration of Helsinki.ResultsBased on the results of regression analysis, clinical environment belongingness had a positive and significant impact on professional identity (β = 0.366, <i>p</i> < 0.001) and professional value (β = 0.676, <i>p</i> < 0.001). Professional value significantly predicted professional identity (β = 0.170, <i>p</i> < 0.001). The indirect effect of clinical environment belongingness on professional identity via professional values was statistically significant (β = 0.115, SE = 0.024, 95% CI = [0.068, 0.162]), and this effect was directly (β = 0.336, SE = 0.034, 95% CI = [0.297, 0.434]) significant.ConclusionsThe new theoretical framework for nurses developed in this study can contribute to professional development. It is further recommended that the promotion of professional value and clinical environment belongingness may be effective in enhancing the professional identity of the nursing staff, as indicated by the results.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"851-863"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflexive moralization: The crucial role of clinician moral well-being.","authors":"Clare Whitney","doi":"10.1177/09697330251339057","DOIUrl":"https://doi.org/10.1177/09697330251339057","url":null,"abstract":"<p><p>BackgroundMoralization, or the application of moral value onto individuals' actions or identities, has broad impact in the context of health and healthcare. In particular, moralization may result in interpersonal and institutional consequences for certain groups of individuals such as people who use substances during pregnancy or while feeding human milk. Reflexive moralization is an underexplored phenomenon that represents the reflex-like nature of some instances of moralization. <b>Objectives:</b> The purpose of this study was to explore and explain how reflexive moralization impacts the perinatal care of substance-exposed dyads.Research DesignIn this targeted sub-analysis, dimensional analysis was used in the mode of emergent fit to analyze qualitative interviews conducted for a parent study investigating the circumstances under which clinicians bring moral considerations into the care of substance-exposed dyads.Participants and Research ContextInterviews with fifteen perinatal health clinician providing health or social care to substance-exposed dyads were included in this analysis.Ethical ConsiderationsThe X IRB determined this study exempt. All participants provided informed consent prior to enrolling in the study.ResultsFindings revealed novel dimensions of reflexive moralization, including the process of sympathization, which occurs when clinicians demoralize and transform their reflexive moralization into a tool for care. In order for the transformative process of sympathization to occur, clinician moral well-being must be assessed as sufficient, meaning clinicians must feel they have the capacity and competence to provide adequate care to patients. <b>Discussion:</b> Future research should further investigate the nature of clinician moral well-being in order to measure and develop interventions to support it.ConclusionsClinician moral well-being plays a pivotal role in clinical care delivery for substance-exposed dyads, in the context of reflexive moralization.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251339057"},"PeriodicalIF":2.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of interventions on conscience: Findings of a systematic review.","authors":"Christina M Lamb, Dimitra V Pouliopoulou, Ken Kirkwood, Kelsey Groenenboom, Megan Kennedy, Edith Pituskin","doi":"10.1177/09697330251333386","DOIUrl":"https://doi.org/10.1177/09697330251333386","url":null,"abstract":"<p><p>Research indicates that conscience is an asset to healthcare professional's personal and professional practice. However, little work has been done to support healthcare professionals to use and understand their conscience for moral decision-making. Disparity exists between international and national bodies that value conscience for healthcare professionals and the paucity of practice supports available to formally assist healthcare professionals to openly discuss and then navigate their moral decisions arising from their conscience. Therefore, the purpose of this systematic review was to examine the effectiveness of existing interventions aimed at supporting healthcare professionals to understand and use their conscience for healthcare practice. This review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Metanalyses. International, interdisciplinary databases including Medline, Embase, PsycINFO, CINAHL, Academic Search Complete, ATLA Religion, Religion and Philosophy Collection, PhilPapers, Scopus and Cochrane Controlled Register of Trials were searched and quantitative as well as qualitative outcomes were reported. We found 11 studies that met the inclusion criteria and underwent data extraction and synthesis. Five interventions were identified that aimed to address aspects of HCP's conscience. No interventions were identified that aim to support healthcare professionals to understand or use their conscience for moral decision-making in practice. Empirical and humanities research indicates that conscience is essential to healthcare practice, but issues of conscience remain a polarizing experience for many HCPs. Intervention and education-based research are therefore needed to support HCP's understanding and use of conscience for practice.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251333386"},"PeriodicalIF":2.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological contract breach mediates ethical climate and deviance among nurses.","authors":"Govind Gopi Verma, Aditya Simha, Hamidha Sharin A, Devika Sai Chandra, Nijanthan Kumar","doi":"10.1177/09697330251328643","DOIUrl":"https://doi.org/10.1177/09697330251328643","url":null,"abstract":"<p><p>BackgroundHealthcare organizations are driven by mission-driven values, yet these values can be compromised in employee-organization relationships. Hospitals present psychologically challenging environments for their nurses, potentially causing breaches of psychological contracts. Despite extensive research on ethical climates, their impact on mitigating interpersonal deviance in healthcare remains understudied. This warrants investigation into how ethical workplace climates and breaches of psychological contracts affect interpersonal deviance in nurses.Research Objective/Purpose/AimThis study investigates how psychological contract breaches mediate the relationship between ethical climates and interpersonal deviance.Research Design/MethodThe study employs a cross-sectional design, collecting data from 230 nurses across five hospitals in India. Standard scales are used to measure the constructs in the study, with established reliability and validity. Structural equation modeling (SEM) was utilized to examine the hypotheses outlined in the study. We also tested the moderating effect of work experience in the moderated mediation model.Ethical considerationsThis study received ethical approval (#ERB-ASBC-2024-027) from the University Ethical Review Board, constituted at Amrita School of Business, Coimbatore.Participants and proceduresPermission to conduct the study was obtained from the hospital administration. Nursing staff participated voluntarily. They were informed about the survey's purpose and their right to withdraw at any time. Consent was obtained on the survey form before recording their responses, and no personal identifiers were collected.FindingsAn ethical workplace climate reduces nurses' interpersonal deviance, mediated by psychological contract breach. This mediation is moderated by work experience, with a stronger effect on less-experienced nurses.ConclusionThe study suggests that regular assessments of ethical workplace climate can aid in planning effective reinforcements at individual, leadership, or organizational level to reduce interpersonal deviance and perceptions of psychological contract breach.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251328643"},"PeriodicalIF":2.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses' ethical competence during the COVID-19 pandemic: Qualitative perspectives.","authors":"Hye Min Byun, Eun Kyoung Yun","doi":"10.1177/09697330251328695","DOIUrl":"https://doi.org/10.1177/09697330251328695","url":null,"abstract":"<p><p>Background Ethical challenges and moral uncertainty are inevitable during infectious disease crises. To support ethical nursing practices, understanding the ethical competencies required in such contexts is essential.ObjectivesThe aim of this study was to explore the phenomenon related to ethical competence among clinical nurses during the COVID-19 pandemic.Research Design, Participants and Research ContextA qualitative explorative approach was used. Data were collected through focus group interviews from 10 clinical nurses working in general and tertiary hospitals in Korea, and analyzed using content analysis.Ethical ConsiderationsThis study was approved by the institutional review board of the university to which the researchers belonged.ResultsThis study derived five core categories-moral solidarity, moral courage, ethical knowledge, ethical decision-making, and ethical reflection-along with their respective components.ConclusionsThis study provides empirical evidence that can contribute to a structured conceptualization of nursing ethical competence for infectious disease crises. Further research is suggested to contribute to practical educational and institutional support to strengthen this competence.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251328695"},"PeriodicalIF":2.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A network analysis of moral distress among clinical internship nursing students: A cross-sectional study.","authors":"Yang Xiong, Ya-Qian Fu, Zhuo-Heng Li, Yu-Rong Tang, Zi-Yu Liu, Bi-Rong Liu, Zhuo-Er Huang, Qi-Feng Yi","doi":"10.1177/09697330251331195","DOIUrl":"https://doi.org/10.1177/09697330251331195","url":null,"abstract":"<p><p>BackgroundMoral distress is a significant challenge faced by clinical internship nursing students. Most current studies investigate the impact of external factors on nursing students' moral distress. However, there is a lack of in-depth exploration of the interactions between various moral distress items.Research objectiveThis study aims to construct a network structure of moral distress among clinical internship nursing students, while exploring the touchpoints of moral sensitivity and moral resilience on moral distress, to identify potential targets for moral distress intervention.Research designA cross-sectional design utilized acceptable validity scales. Network analysis was conducted using R (Version 4.4.0). Regularized partial correlation was utilized to describe the associations between different nodes in the network. Central nodes were identified through centrality indices.Participants and research contextThe participants in this study are 372 nursing students undergoing clinical internships at a comprehensive teaching hospital in Changsha, China.Ethical considerationsThis study was approved by the hospital ethics committee (Review Number: Express 241098). Written informed consent was obtained from all participants.ResultsIn the moral distress network, the connections between MD3 \"I provide life-sustaining treatment per the family's wishes\" and MD4 \"Despite only extending survival, I implement life-saving measures\" are the strongest. MD18 \"Decline in service quality due to poor team communication,\" MD19 \"I ignore situations lacking adequate information for informed consent,\" and MD17 \"I collaborate with colleagues unable to meet the patient's treatment needs\" are the central nodes of the moral distress network. In the relational network, MD19 is a critical connection point linking moral distress with moral sensitivity and moral resilience.ConclusionFuture interventions for moral distress could focus on the strongly related and significant distress (MD3, MD4, MD18, MD19, MD20, and MD17) mentioned in this study, and develop scientific and targeted interventions to reduce clinical internship nursing students' moral distress.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251331195"},"PeriodicalIF":2.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing care in assisted dying: Plasticity and relational commitment.","authors":"Maria Feijoo-Cid, Maria Verdaguer, Xavier Busquet-Duran, Eduard Moreno-Gabriel, Miquel Domènech, Lupicinio Iñiguez-Rueda, Núria Vallès-Peris, Patricia Beroiz-Groh, Gloria Cantarell-Barella, Pere Torán-Monserrat, Antonia Arreciado Marañón","doi":"10.1177/09697330251333378","DOIUrl":"https://doi.org/10.1177/09697330251333378","url":null,"abstract":"<p><p>BackgroundSpain's Euthanasia Law came into force in 2021. Nurses are involved throughout the entire process and yet the law only recognizes their role in the final administration of the drug.ObjectiveTo understand the practice and experience of nurses involved in the euthanasia process.Research designQualitative study with a phenomenological approach. An interpretative phenomenological analysis was conducted using ATLAS-ti.Participants and research contextThis study is part of a larger project for which the study population comprised professionals who have participated in the euthanasia process in Catalonia since the law came into force. This study is based on data collected from nurses through 6 in-depth interviews and 3 focus groups.Ethical considerationsThis study was approved by the Ethics Committee (22/094-P). All participants granted their informed consent. Interviews and focus groups were anonymized.FindingsThe results revolve around two themes: (1) Plasticity of nursing care in the face of regulatory gaps and (2) managing emotions while providing assisted dying. Nurses respond to patients and families by adapting to the demands of the process and self-managing any emotions that arise from participating in this practice. Nurses use rationalization to manage the range of emotions they experience resulting from the tension between respecting a person's autonomous decision to request euthanasia and upholding their professional duty to prevent harm. The team stands out as a crucial element in managing these emotions.ConclusionsSpanish nurses are involved throughout the entire euthanasia process, demonstrating great plasticity of care. Euthanasia care is complex and the relational context between professionals and the patient/family and between team members is key. The law should define and envisage the role of nurses, as it does for other professions.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251333378"},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical and equity challenges in employment: Perspectives of international nursing graduates.","authors":"Animesh Ghimire, Yunjing Qiu","doi":"10.1177/09697330251333397","DOIUrl":"https://doi.org/10.1177/09697330251333397","url":null,"abstract":"<p><p>BackgroundAustralia faces a critical shortage of nurses, yet international nursing graduates (INGs) encounter significant barriers to securing employment after graduation. Current policies often prioritize domestic graduates, creating systemic disadvantages for INGs, particularly those on temporary visas. This inequity raises ethical concerns and undermines Australia's ability to fully utilize its nursing workforce, potentially compromising the quality of healthcare services.AimThis study explores the lived experiences of INGs regarding employment challenges in Australia, critically examining the ethical and equity implications of existing practices.Research Design A qualitative study employing a combined phenomenological and exploratory approach was conducted. Data were analyzed using a thematic analysis framework.Participants and Research ContextTwelve international nursing students in their final semester of the Bachelor of Nursing program at two metropolitan universities in Australia participated in semi-structured interviews.Ethical ConsiderationsEthical approval was obtained from the Monash University Human Research Ethics Committee (MUHREC-44400) and the University of Technology Sydney (ETH24-10028). Informed consent was obtained from all participants, who were assured of their right to confidentiality and to withdraw from the study at any time.ResultsFive overarching themes emerged: (1) Economic Disparity and Ethical Considerations, (2) Systemic Discrimination and Inequality, (3) Mental Health and Well-being, (4) Policy and Regulatory Barriers, and (5) Lack of Cultural Inclusion and a Sense of (Un)Belongingness.ConclusionsThe findings highlight urgent ethical concerns and equity challenges that demand comprehensive reforms to create a more inclusive and ethically sound environment for INGs in Australia. These reforms necessitate policy changes to address discriminatory practices and visa restrictions, enhanced institutional support to facilitate INGs' transition into the workforce, and a commitment to cultural competence and inclusion at all levels of the healthcare system. Addressing these systemic barriers is not only a matter of fairness and justice but is also crucial for ensuring a robust and ethically sustainable healthcare workforce in Australia.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251333397"},"PeriodicalIF":2.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical reflections of healthcare staff on 'consentless measures' in somatic care: A qualitative study.","authors":"Joar Björk, Niklas Juth, Tove Godskesen","doi":"10.1177/09697330251328649","DOIUrl":"https://doi.org/10.1177/09697330251328649","url":null,"abstract":"<p><p>BackgroundMany patients in medical wards lack decision-making capacity and cannot provide valid consent. As a result, nurses and other healthcare professionals often face a dilemma: whether to neglect the medical needs of such patients, or provide healthcare interventions without obtaining valid consent. Previous studies have indicated that many interventions are provided without consent; however, there is insufficient knowledge about how staff in this context reason about the ethical dilemmas they encounter.AimTo explore the ethical reasons provided by nurses and other healthcare professionals in medical wards for and against providing healthcare interventions without patients' consent.Research designThe study employed a qualitative explorative design. Eight focus group interviews were held with 37 staff across five different professions, mainly nurses, at two Swedish hospitals. The material was subjected to qualitative analysis, following a Reflective Thematic Analysis framework.Ethical considerationsEthical approval for this study was obtained from the Swedish Ethical Review Authority. All participants were informed orally and in writing about the study's aims and its voluntary nature. No sensitive personal information was registered. Participants provided their oral consent to participate before the interviews took place.Findings/ResultsThematic analysis resulted in four main themes: <i>Coercion is a bad word</i>; <i>Reasons to accept coercion</i>; <i>Coercion is part of ward culture,</i> and <i>Unacceptable coercion.</i>ConclusionsParticipants overwhelmingly supported the current use of 'consentless measures' at the investigated wards. Most situations described either needed no justification, according to participants, or could be easily justified by reference to the benefit of the patient, the patient's poor decision-making capacity, or the benefit of others. A range of implicit, contextual, and institutional justifications were also given. Suboptimal ward culture was considered a prime driver of consentless measures and a force that compromises nurses' agency in the patient encounter.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251328649"},"PeriodicalIF":2.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}